appendicular phlegmon

BACKGROUND: The management of appendiceal mass is surrounded with controversy. Traditional management has been conservative, with interval appendicectomy performed weeks after the mass had resolved. This remains the most common approach at many centers in the world. Recently, an increasing number of studies have challenged this approach. This article reviews some of the controversial issues in the management of appendix mass, assesses current practice and suggests an appropriate approach for the management of appendix mass...

Laparoscopic appendectomy (LA) is a well spread method today, but not as largely accepted as cholecystectomy, the cure of gastro-esophageal reflux and some other procedures (relatively small in number) for which the laparoscopic approach is the golden standard. Otherwise it is improbable that LA will gain such a status, at least in the near future. On the other hand it is obvious that LA offers important advantages for some special situations: the right iliac area syndrome, obesity, professional sportsmen, abnormal localization of the appendix, as well for the cases when localized and especially diffuse peritonitis is associated...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Complications, occurred after the operation for appendicular peritonitis in children, were analyzed. The frequency of the complications occurrence in patients with an acute catarrhal appendicitis had constituted 1.4%, with phlegmonous one--3.5%, gangrenous--12.1%, gangrenous appendicitis with local restricted peritonitis--18.9%, with diffuse purulent peritonitis--42%. The dependence of the complications frequency on character and severity of primary changes in abdominal cavity was established.

OBJECTIVE: To establish the accuracy of unenhanced CT in the preoperative diagnosis of acute appendicitis. DESIGN: Accuracy study, prospective and blinded. SETTING: The University Hospital. PARTICIPANTS: 52 patients with clinical and laboratorial manifestations of acute appendicitis. CT diagnosis was made by: presence of an abnormal appendix, appendiceal calculi with pericecal phlegmon or alterations in the pericecal appendicular site and absence of signs that may lead to other diagnosis...

The management of appendicular mass seems to be taking turn with the availability of better antibiotics, care and anaesthesia. Quite a few workers turned to the other extreme of traditional conservative approach and reported acceptable results with immediate intervention during phlegmonous stage. But practically, surgeons still continue to adopt the same old regime. To alleviate this fear and circumvent the disadvantages of immediate intervention a midpath regime called early appendicectomy has been clinically evaluated...

The authors report a case of a 93-year-old man with villous adenoma causing acute phlegmonous appendicitis. The appendicular localization, extremely uncommon, is the cause of an acute appendicitis in 50% of cases. Therefore, they analyse the anatomo-pathological, clinical, diagnostic and therapeutic aspects of this pathology with the help of the literature.

The article generalizes the first experience in successful laparoscopic appendectomies in children carried out by the method suggested by F. Götz et al. which we modified and adapted to pediatric practice. In all cases of acute appendicitis the laparoscopic manipulation began with the diagnostic stageo by performing two abdominal punctures with small-diameter trocars. Laparoscopic appendectomy was undertaken only in recognized destructive appendicitis. It was conducted 205 times in children 2 to 14 years old in various localization of the vermiform process, including subhepatic and retroperineal...

Analysis of the results of treatment of 240 patients with generalized peritonitis of appendicular origin showed that the application of hemosorption led to noticeable and stable diminution of intoxication in 84% of cases. In the ++post-sorption period, the severity of endotoxicosis did not change essentially in 12% of cases and increased in the remaining cases. The therapeutic effect of hemosorption was found to be unstable in patients with signs of multiple organ insufficiency developing in prolonged poorly effective therapy as well as in patients with unrecognized abdominal abscesses, incompetence of the sutures of anastomoses, thrombosis of the mesenteric vessels, and early intestinal obstruction due to adhesions...

The clinical usefulness of laboratory tests was examined in 258 patients admitted to the emergency room with the general practitioner's tentative diagnosis, acute appendicitis. Acute appendectomy was performed on 91 patients. Histological examination of the appendix confirmed the diagnosis in 69 cases (acute appendicitis 20, phlegmonous appendicitis 36, perforation 13). Seven patients with appendicular infiltrate were not subjected to operation but the diagnosis was clear from clinical examination. On close examination/operation by the surgical team, 96 admitted patients were excluded from the primary diagnosis, acute appendicitis, and served as a control group...

An analysis of clinical effectiveness of antibacterial therapy, photomodification of autoblood, hemosorption and their combinations was made in 395 patients with acute appendicitis. It was established that no antibacterial and desintoxicating therapy is required in catarrhal appendicitis. The prophylactic application of photomodification of autoblood is thought to be most expedient for phlegmonous appendicitis at the postoperative period, a combination of antibacterial therapy and photomodified autoblood--for gangrenous appendicitis, a combination of antibacterial therapy, photomodification of autoblood and hemosorption--for appendicular diffuse suppurative peritonitis...

Among 976 children with acute appendicitis 966 were operated upon, 169 of them (17.4%)-for common appendicitis, 401 (41.2%)-for phlegmonous appendicitis, 396 (40.4%)-for gangrenous appendicitis; 10 children were subjected to surgery due to the presence of appendicular infiltration. Preoperatively, in 137 (13.7%) patients peritonitis was observed: local-in 90, diffuse and progressive-in 47. There was noted a dependence of complications on the terms of the disease and patients' stay at the hospital prior to surgery...

The authors report twenty three cases of intestinal yerseniosis revealed among 575 patients operated upon for acute appendicitis. The diagnosis was supported bacteriologically and serologically. The disease proceeded with a predominant involvement of the appendicular process. Various forms of acute appendicitis were observed. Common appendicitis was noted in 6 cases, phlegmonous--in 15, gangrenous--in 2.

No abstract text is available yet for this article.

The authors compared the clinical and pathoanatomical diagnoses in 1399 patients, operated upon for catarrhal appendicitis. In 123 children the clinical diagnosis was revised as a result of further observations following surgery. In 1276 patients the clinical diagnosis of catarrhal appendicitis was remained. An exploration of the appendicular process in these patients supported the diagnosis in 748 cases (58.6%). In 16 cases chronic appendicitis was recognized, in 111 -- phlegmonous and gangrenous appendicitis (8...